NFM Salute (Frontline Edition): Deborah Toole, RN

2020 11-05  |   NFM TV

Deborah Toole is a hospice (end of life) and palliative care (pain management) nurse. She always thought she would be a nurse, even writing a paper about being a nurse in first grade. In high school, she began going to nursing school part time. After beginning her career as a Registered Nurse (RN), a best friend’s husband died of brain cancer. While taking care of him, she had a life-affirming moment. Hear about it in this special NFM Salute – Frontline Edition.

Full Transcript is Below:

- Welcome into a special NFM Salute - Frontline Edition. I'm your host, Greg Sher. Joining us today is Deborah Toole. She is a hospice and palliative care nurse at Gilchrist, which is a facility in Towson , Maryland. She joins us from Towson, Maryland right now. We really appreciate you being with us Deborah. How are you today?

 

- I'm great, Thank you.

 

- Thanks for being with us. Tell us about Gilchrist, what does Gilchrist do?

 

- Gilchrist does counseling and support services. It has elder medical care and hospice care. It's a trifecta.

 

- It is quite a trifecta. So you in particular deal with hospice care in the homes of people whose lives are basically coming to an end, right?

 

- Yep, that is actually correct.

 

- So what's that process like, how do you, at what point do you get involved?

 

- I get involved once two doctors determine that if the disease trajectory follows a certain path and they only have six months or less to live, then they come on hospice.

 

- So how do you get into this? I mean, when did you end up landing in such a unique position?

 

- My best friend's husband was terminally ill with a brain tumor, and he was 32 with a two year old and a four year old. And so I just helped take care of him being a nurse, but not really understanding what I was doing. And it was just moved me to the point of, I knew I needed to do this, it is a calling and a passion, it's definitely not a job.

 

- What are some questions that you get asked by people that are fascinated by what you do?

 

- I get the, "Oh, how can you do this? This must be so hard. And how do you know when it's going to happen and how do you care for them afterwards?" And that's why I think Gilchrist is so great because it has a multidisciplinary team of social workers and chaplains and home health aids, and nurses and doctors, and everybody that can meet the family where they are and meet the patient where they are. And I had so many people say, "this should be the model of care everywhere" because they're really taking care of all their needs, their equipment, their medicine, everything that they need."

 

- What are some of the biggest challenges that the families face in these critical last moments and how do you help them get through it?

 

- I think that a lot of the patients that I have really have the perspective that they want quality of care. They want to be able to do things at the end. They want to be able to enjoy their family, enjoy food and families really, a lot of them are into quantity. They really want the longevity. They want them to be around as long as possible. I mean, you have a man and a woman who's been together 68 years. They're not ready to give up on them, nor should they, but it just makes the transition really hard when they sometimes would rather them be awake and in pain, than asleep and comfortable because it's just so painful for them to watch the demise of somebody that is their other half, that they've had their whole life. And then they're lost afterwards.

 

- What are some of the conversations like when you're alone with the patient and they realize that they are living on limited time, and they're looking back and wanting to talk to someone about that, how deep and real are those moments?

 

- Those moments are very deep and real, especially when the family is not in the room. A woman who for six months lived on the little Reese's Peanut Butter Easter Eggs and every time her daughter would give her one she'd eat it and then her daughter would leave she'd spit it out. And she, I was like, "why are you eating these?" She said, "cause it makes my daughter feel better, but not me." And you do things for the family, like you eat for the family. And we talk about what life is like, and when they're spiritual and I'm spiritual. So when they have that connection of faith, we can talk about some very great and deep things and laugh. Every single one of my patients, I laugh with them, I dance with them, I sing with them. When I'm still alive, I still want to be alive. And I want these people to know you're still alive.

 

- Does it still get to you? Or does it still pull you at your heartstrings every time? Or is it just something you're so used to at this point.

 

- I am still very empathetic. I think it hasn't hardened me, but it's made me realize that this is such a part of life, but I bring so much to the families from what the families have taught me, that everyone, every single one of my families is literally is just, they're just so special. And you just learn so much. I feel like I take away more from my families than I could ever give them. I just wrote two blogs for Gilchrist. I do pediatric hospice too. And so one was on a pediatric hospice patient who'd passed away and their family at the death visit, which was really that one that impacted me for the rest of my life. And the point of the blog was show love and when necessary use words. You don't really need to use words. You have to come in there and you're a guest in their home, and they've just lost the most precious thing to them, their child. And so how do you navigate doing your nursing part, but not taking away from the sacredness of the moment of right then of what they're experiencing. And so everything from like the little boy holding his teddy bear and the mom's grieving at the bedside and crying, and you know, I've got to listen to the heartbeat because it's Maryland law, but she's feeling like I gotta move the teddy bear. I'm like, "you don't need to move the teddy bear. I'll come around, underneath, upside to put it there and you stay next to him." Like how can I be incognito and come out and do my thing and leave, and then not take away from what they built up to that time.

 

- That's so powerful and moving. And I can't help but think about my two young boys. I'm sure anyone watching this, is gonna go home tonight and hug their loved one a little bit tighter. You know, thanks to the perspective that you've given us, Deborah. Really appreciate it. Deborah Toole, registered nurse. Thank you so much for agreeing to be our NFM Salute - Frontline Edition. We really appreciate your time. Wish you continued success.

 

- It's my pleasure, thank you.

 

- I'm Greg Sher. We'll see you again next time.

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